Dataset Information

Are Sluggish Cognitive Tempo, ADHD, and Oppositional Defiant Disorder Trait- or State-Like Constructs from Prekindergarten to Fourth Grade?

ABSTRACT: The objective was to determine the proportion of trait (consistency across occasions) and occasion-specific variance in sluggish cognitive tempo (SCT), attention deficit/hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) symptom ratings. A single trait factor-multiple state factors model was applied to parent ratings of SCT, ADHD-IN, ADHD-HI, and ODD symptoms for 978 children (50% female) across prekindergarten (M = 4.90 years), kindergarten (M = 6.27 years), 1st-grade (M = 7.42 years), 2nd-grade (M = 8.45 years), and 4th-grade (M = 10.45 years) assessments. For the prekindergarten assessment, SCT, ADHD-IN, ADHD-HI, and ODD contained more occasion-specific than trait variance (54%, 64%, 56%, and 55% occasion-specific variance, respectively). In contrast, SCT, ADHD-IN, ADHD-HI, and ODD contained more trait than occasion-specific variance for the kindergarten through 4th-grade assessments (62%-72%, 65%-68%, 71%-75%, and 60%-69% trait variance, respectively). SCT, ADHD-IN, ADHD-HI, and ODD are slightly to moderately more state-like than trait-like during the prekindergarten developmental period but are more stable traits than fluctuating states from kindergarten to 4th grade. Findings indicate that, particularly after children start formal schooling, these psychopathology dimensions are primarily stable traits; implications for assessment are discussed.

SUBMITTER: Burns GL

PROVIDER: S-EPMC6800749 | biostudies-literature | 2020 Jul-Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Are Sluggish Cognitive Tempo, ADHD, and Oppositional Defiant Disorder Trait- or State-Like Constructs from Prekindergarten to Fourth Grade?

Burns G Leonard GL Becker Stephen P SP Geiser Christian C Leopold Daniel R DR Willcutt Erik G EG

Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 20190415 4

The objective was to determine the proportion of trait (consistency across occasions) and occasion-specific variance in sluggish cognitive tempo (SCT), attention deficit/hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) symptom ratings. A single trait factor-multiple state factors model was applied to parent ratings of SCT, ADHD-IN, ADHD-HI, and ODD symptoms for 978 children (50% female) across prekindergarten (<i>M</i> = ...[more]

PMID: 30985190

Similar Datasets

Project description:BackgroundSluggish cognitive tempo (SCT) is distinct from attention-deficit/hyperactivity disorder inattention (ADHD-IN) and concurrently associated with a range of impairment domains. However, few longitudinal studies have examined SCT as a longitudinal predictor of adjustment. Studies to date have all used a relatively short longitudinal time span (6 months to 2 years) and only rating scale measures of adjustment. Using a prospective, multi-method design, this study examined whether SCT and ADHD-IN were differentially associated with functioning over a 10-year period between preschool and the end of ninth grade.MethodsLatent state-trait modeling determined the trait variance (i.e. consistency across occasions) of SCT and ADHD-IN across four measurement points (preschool and the end of kindergarten, first grade, and second grade) in a large population-based longitudinal sample (N = 976). Regression analyses were used to examine trait SCT and ADHD-IN factors in early childhood as predictors of functioning at the end of ninth grade (i.e. parent ratings of psychopathology and social/academic functioning, reading and mathematics academic achievement scores, processing speed and working memory).ResultsBoth SCT and ADHD-IN contained more trait variance (Ms = 65% and 61%, respectively) than occasion-specific variance (Ms = 35% and 39%) in early childhood, with trait variance increasing as children progressed from preschool through early elementary school. In regression analyses: (a) SCT significantly predicted greater withdrawal and anxiety/depression whereas ADHD-IN did not uniquely predict these internalizing domains; (b) ADHD-IN uniquely predicted more externalizing behaviors whereas SCT uniquely predicted fewer externalizing behaviors; (c) SCT uniquely predicted shyness whereas both SCT and ADHD-IN uniquely predicted global social difficulties; and (d) ADHD-IN uniquely predicted poorer math achievement and slower processing speed whereas SCT more consistently predicted poorer reading achievement.ConclusionsFindings of this study - from the longest prospective sample to date - provide the clearest evidence yet that SCT and ADHD-IN often differ when it comes to the functional outcomes they predict.

Project description:ObjectiveSluggish cognitive tempo refers to a constellation of symptoms that include slowed behavior/thinking, reduced alertness, and getting lost in one's thoughts. Despite the moniker "sluggish cognitive tempo," the evidence is mixed regarding the extent to which it is associated globally with slowed (sluggish) mental (cognitive) information processing speed (tempo).MethodA well-characterized clinical sample of 132 children ages 8-13 years (M = 10.34, SD = 1.51; 47 girls; 67% White/non-Hispanic) were administered multiple, counterbalanced neurocognitive tests and assessed for sluggish cognitive tempo symptoms via multiple-informant reports.ResultsBayesian linear regressions revealed significant evidence against associations between sluggish cognitive tempo and computationally modeled processing speed (BF01 > 3.70), and significant evidence for associations with slower working memory manipulation speed. These findings were consistent across parent and teacher models, with and without control for attention-deficit/hyperactivity disorder inattentive symptoms and IQ. There was also significant evidence linking faster inhibition speed with higher parent-reported sluggish cognitive tempo symptoms.ConclusionsThese findings provide strong evidence against characterizing children with sluggish cognitive tempo symptoms as possessing a globally sluggish cognitive tempo. Instead, these symptoms appear to be related, to a significant extent, to executive dysfunction characterized by working memory systems that are too slow and inhibition systems that are too fast. Behaviorally, these findings suggest that requiring extra time to rearrange the active contents of working memory delays responding, whereas an overactive inhibition system likely terminates thoughts too quickly and therefore prevents intended behaviors from starting or completing, thereby giving the appearance that children are absent-minded or failing to act when expected. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Project description:IntroductionThe externalizing disorders of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are common in adolescence and are strong predictors of adult psychopathology. While treatable, substantial diagnostic overlap complicates intervention planning. Understanding which factors predict the onset of each disorder and disambiguating their different predictors is of substantial translational interest.Materials and methodsWe analyzed 5,777 multimodal candidate predictors from children aged 9-10 years and their parents in the ABCD cohort to predict the future onset of ADHD, ODD, and CD at 2-year follow-up. We used deep learning optimized with an innovative AI algorithm to jointly optimize model training, perform automated feature selection, and construct individual-level predictions of illness onset and all prevailing cases at 11-12 years and examined relative predictive performance when candidate predictors were restricted to only neural metrics.ResultsMultimodal models achieved ~86-97% accuracy, 0.919-0.996 AUROC, and ~82-97% precision and recall in testing in held-out, unseen data. In neural-only models, predictive performance dropped substantially but nonetheless achieved accuracy and AUROC of ~80%. Parent aggressive and externalizing traits uniquely differentiated the onset of ODD, while structural MRI metrics in the limbic system were specific to CD. Psychosocial measures of sleep disorders, parent mental health and behavioral traits, and school performance proved valuable across all disorders. In neural-only models, structural and functional MRI metrics in subcortical regions and cortical-subcortical connectivity were emphasized. Overall, we identified a strong correlation between accuracy and final predictor importance.ConclusionDeep learning optimized with AI can generate highly accurate individual-level predictions of the onset of early adolescent externalizing disorders using multimodal features. While externalizing disorders are frequently co-morbid in adolescents, certain predictors were specific to the onset of ODD or CD vs. ADHD. To our knowledge, this is the first machine learning study to predict the onset of all three major adolescent externalizing disorders with the same design and participant cohort to enable direct comparisons, analyze >200 multimodal features, and include many types of neuroimaging metrics. Future study to test our observations in external validation data will help further test the generalizability of these findings.

Project description:To examine whether sluggish cognitive tempo (SCT) symptomatology moderates dose response to methylphenidate and whether the impact of SCT on medication response is distinct from attention-deficit/hyperactivity disorder (ADHD) subtype effects. Stimulant-naive children with ADHD predominantly inattentive type (ADHD-I; n = 126) or ADHD combined type (ADHD-C; n = 45) aged 7-11 years were recruited from the community from September 2006 to June 2013 to participate in a prospective, randomized, double-blind, 4-week crossover trial of long-acting methylphenidate. ADHD diagnosis and subtype were established according to DSM-IV criteria using a structured interview and teacher ADHD symptom ratings. SCT symptoms were assessed using a teacher-rated scale with 2 factors (Sluggish/Sleepy and Daydreamy). Primary outcomes included (1) categorization of children as methylphenidate responders, methylphenidate nonresponders, or placebo responders by 2 blinded physicians and (2) parent and teacher ratings of child behavior on the Vanderbilt ADHD Diagnostic Rating Scales while subjects were on treatment with placebo or 1 of 3 methylphenidate dosages (low, medium, high). Increased SCT Sluggish/Sleepy factor scores were associated with being a methylphenidate nonresponder or placebo responder rather than a methylphenidate responder (P = .04). Sluggish/Sleepy factor scores were also linked to diminished methylphenidate dose response for parent- and teacher-rated inattention symptoms (Sluggish/Sleepy factor × dose P = .004). SCT Daydreamy symptoms and ADHD subtype (ADHD-I vs ADHD-C) were not associated with methylphenidate responder status and did not moderate methylphenidate dose response for inattention symptoms. SCT Sluggish/Sleepy symptoms, but not SCT Daydreamy symptoms or ADHD subtype, predicted methylphenidate nonresponse. This novel finding, if replicated, may have important implications for assessing SCT as part of ADHD care. ClinicalTrials.gov identifier: NCT01727414.

Project description:The co-occurrence Oppositional Defiant Disorder (ODD) in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has been associated to difficulties in regulating adverse states, elevated functional impairment, deficits in Executive Functions and high risk for psychopathology. Recent studies have shown that ODD is a negative predictor of a positive response to methylphenidate (MPH) treatment for ADHD symptoms in children and adolescents and that patients with a diagnosis of comorbid ADHD and ODD are less likely to respond favorably to pharmacological treatment with MPH. We conducted a naturalistic study to understand the clinical characteristics of drug-naïve children and adolescents with ADHD that influence the response to MPH by measuring the effect on attention. Specifically, we investigated whether a single dose of MPH differently affects the performance of 53 children and adolescents with ADHD with or without ODD comorbidity. In addition, participant characteristics such as symptom severity, functional impairment, and associated behavioral and emotional symptoms at baseline were examined to better understand what aspects affect the response to MPH. We found that a single dose of MPH improved the attention of children and adolescents with ADHD without ODD more than those with comorbid ADHD and ODD, resulting in reduced reaction times. Our findings indicated that children and adolescents with comorbid ADHD and ODD and those with ADHD alone did not exhibit differences in measures of attention prior to taking MPH, nor in demographic variables (age, intelligence quotient, gender), clinical characteristics related to symptom severity, and adaptive behaviors. However, we observed differences between the two groups in certain behavioral aspects, including the Dysregulation Profile and disruptive behaviors. Assessing symptoms in combination with the presence of ADHD can be beneficial in determining which individuals would derive the greatest benefits from treatment.

Dataset Information

Are Sluggish Cognitive Tempo, ADHD, and Oppositional Defiant Disorder Trait- or State-Like Constructs from Prekindergarten to Fourth Grade?

Publications

Are Sluggish Cognitive Tempo, ADHD, and Oppositional Defiant Disorder Trait- or State-Like Constructs from Prekindergarten to Fourth Grade?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets